Kamran Ali, Jennings Russell W
Department of General Surgery, Harvard Medical School, Boston Children's Hospital, Boston, MA, United States.
Front Pediatr. 2019 Dec 12;7:512. doi: 10.3389/fped.2019.00512. eCollection 2019.
Tracheobronchomalacia (TBM) refers to airway collapse due to typically excessive posterior membrane intrusion and often associated with anterior cartilage compression. TBM occurs either in isolation or in association with other congenital or acquired conditions. Patients with TM typically present non-specific respiratory symptoms, ranging from noisy breathing with a typical barking cough to respiratory distress episodes to acute life-threatening events and recurrent and/or prolonged respiratory infections. There are no definitive standardized guidelines for the evaluation, diagnosis, and treatment of TBM; therefore, patients may be initially misdiagnosed and incorrectly treated. Although milder cases of TBM may become asymptomatic as the diameter of the airway enlarges with the child, in cases of severe TBM, more aggressive management is warranted. This article is an overview of the clinical presentation, evaluation, diagnosis, medical management, and surgical treatment options in pediatric tracheomalacia.
气管支气管软化症(TBM)是指由于通常过度的后膜侵入导致气道塌陷,且常伴有前软骨受压。TBM可单独发生,也可与其他先天性或后天性疾病相关。患有TBM的患者通常表现出非特异性呼吸道症状,从伴有典型犬吠样咳嗽的呼吸嘈杂到呼吸窘迫发作,再到急性危及生命的事件以及反复和/或长期的呼吸道感染。目前尚无用于评估、诊断和治疗TBM的明确标准化指南;因此,患者最初可能会被误诊和错误治疗。尽管随着儿童气道直径增大,较轻的TBM病例可能会无症状,但对于严重的TBM病例,则需要更积极的治疗。本文概述了小儿气管软化症的临床表现、评估、诊断、药物治疗和手术治疗选择。